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• A prostate gland is an accessory gland of male reproductive system that wraps around the male urethra near the bladder.
• Prostate gland developed at age of 12 years, and it starts growing in middle age.
• The prostate surrounds the urethra, the tube that carries urine from the bladder through the penis and outside the body.
• Prostate gland contains crucial enzyme, 5-alpha-reductace which converts the hormones testosterone in the body to DHT.
• BPH/BPE is a condition that occurs when the prostate gland enlarges, potentially slowing or blocking the urinary stream.
• Other names for benign prostatic hyperplasia include benign prostatic hypertrophy and an enlarged prostate.
• The prostate normally enlarges to some degree in all men with advancing age, although not all men require treatment.
• As the prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful.
• "Benign" means the enlargement isn't caused by cancer or infection.
• "Hyperplasia" means enlargement.
The symptoms of BPH can likely begin after an age between 40 to 50 years and only in men. The most common symptoms of BPH include:
• Frequent urination (able to hold less than 2 hours)
• Getting up in the night for urination (Nocturia)
• Sudden desire to pass urine (Urgency) or leakage of urine (Urgency incontinence)
• A hesitant, interrupted, or weak stream of urine
• Failure to pass urine (urinary retention)
• Dribbling of urine
• Incomplete emptying of the bladder
• Blood in Urine
• Frequent urinary tract infection
• Straining during urination
To know if BPH or any another problem is causing symptoms, a urologist will ask you questions, perform an examination and will order few tests as below:
• Rectal examination – Your urologist will need to perform a rectal examination to feel the size and shape of the prostate gland.
• Urinalysis – You might be asked for a urine sample to see if you have a urinary tract infection, diabetes, or certain kidney disorder.
• Blood tests – A blood test to check the prostate-specific antigen (PSA) level is often recommended.
• Ultrasound test – A USG test to know the size of prostate, thickness of bladder and structure of kidneys and post void residual urine.
• Uroflowmetry Test – This is a special kind of test to know how much prostate gland is obstructing the urethra.
• PSA, or prostate-specific antigen, plays a role as one of the diagnostic markers though it is non-specific.
• Elevated PSA levels may indicate BPH or Prostate gland infection or Prostate cancer and needs to be evaluated further.
• Regular PSA screenings can aid in monitoring prostate health and detecting potential issues like prostate cancer in their early stages.
• Watchful waiting – If symptoms are mild and not bothersome, then regular monitoring is what all is needed and don't need the treatment right away.
• Medicines – There are 2 types of medicine commonly used to treat BPH. One type relaxes the muscles that surround the urethra, and another reduces the size of prostate.
• Surgery – There are several ways to treat BPH with surgery. They can involve removing obstructing prostate and making the urethra wider so that more urine can flow through easily.
• It is also known as Holmium LASER enucleation of prostate (HoLEP)/ Thulium fibre LASER enucleation of prostate (ThuLEP)?
• There are different types of laser prostate surgeries, but they all involve the use of laser energy to remove or vaporize excess prostate tissue that is causing urinary issues.
• Best approach is LASER enucleation, which involves removing the inner part of the prostate to alleviate urinary symptoms.
• Laser prostate surgery is often considered as a minimally invasive option compared to traditional surgical methods, and it may result in less bleeding and a faster recovery.
• LASER prostate surgery is performed by endoscopy method, that means a tiny camera will insert in urethra along with an energy source used which is a LASER fiber.
• It doesn’t involve any surgical cut over the body and performed through urethra.
• Try to avoid constipation. Eat foods that have a lot of fiber.
• Drink plenty of water, especially if your urine looks red or you pass small blood clots. It is normal for your urine to have a small amount of blood in it right after surgery.
• Avoid lifting weighted things for some time.
• Avoid smoking and alcohol intake.
• Increase your activity slowly – Start with short walks around your home and walk a little more each day.
• Take prescribed medication as advised.
